Creating a Shared Values Agenda
to Advance Child Health
Sandra G. Hassink, MD, MSa, Bradley F. Hutchins, MAb
The factors that affect the health of
children cross all sectors of society,
as do the resources, skills, and talents
needed to improve child health.1–3
Health care providers and organizations
are challenged in addressing these
health conditions within the bounds
of the health care system and are
increasing their involvement in
community-based efforts to improve
health by working together in
collaborative efforts that involve
multiple sectors and stakeholders,
including the corporate sector.4
a
President and bDirector of Development, American
Academy of Pediatrics, Elk Grove, Illinois
www.pediatrics.org/cgi/doi/10.1542/peds.2015-3438
DOI: 10.1542/peds.2015-3438
Accepted for publication Sep 25, 2015
Address correspondence to Sandra Hassink, MD,
American Academy of Pediatrics, 141 Northwest Pt
Blvd, Elk Grove Village, IL 60007-1019. E-mail:
[email protected]
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online,
1098-4275).
Copyright © 2015 by the American Academy of
Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated
they have no financial relationships relevant to this
article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have
indicated they have no potential conflicts of interest
to disclose.
COMMENTARY
It is important for the American
Academy of Pediatrics (AAP) to
interact with the corporate sector in a
way that emphasizes its mission, vision,
and values, in addition to the traditional
guidelines that focused on financial
transparency and the management
of conflict of interest.5 For example,
the AAP has endorsed the Council
on Medical Subspecialty Societies
guidelines,6 which provide guidance to
member societies in the development
of policies and procedures that
safeguard the independence of their
programs, policies, and advocacy
positions. In addition to these
guidelines, the AAP has developed a
robust mechanism for identifying and
resolving conflicts of interest. However,
there has been recognition by leadership
that although crucial, these safeguards
did not provide a mechanism for
explicitly identifying and discussing
mission alignment that would allow
increased collaboration and collective
impact. As a consequence, the AAP
developed a tool to move the conversation
toward one that is values based and
mission oriented, borrowing from the
concept of “shared values.” This
concept has been in circulation in the
corporate world since 2006, when
it was advanced by Porter and
Kramer to describe ways in which
corporations could meet their mission
of sustainability and profitability while
also achieving positive social aims.7
The Academy’s use of the term “shared
values” is derived from this concept.
The shared values pyramid was
developed to go beyond the traditional
guidelines for industry into a
discussion that focused on shared
organizational culture, values, and
mission to ensure that the AAP’s
relationships with corporate funders
and partners serve the best interests
of children (Fig 1).
There are 4 levels describing the
nature of organizational relationships:
transactional, short-term interactional,
values shared, and child health mission
collaboration. The following are
descriptions and examples of the
4 levels drawn from actual
relationships.
A transactional relationship is
constructed to meet an immediate
need, such as when a new educational
offering is developed (patient brochure,
toolkit, or book) that provides a discrete
opportunity for corporate visibility
and interaction in real time. These are
often 1-time opportunities, and funders
engage to fulfill their objective around
a single issue or specific focus. Many
interactions appropriately remain at
this level of engagement.
Short-term interactional relationships
involve organizations supporting
associations between each other
that move forward a priority that is
related directly or indirectly to one
PEDIATRICS Volume 136, number 6, December 2015
The right side of the pyramid
illustrates potential outcomes of the
relationship starting with relatively
simple brand identification at the
transactional stage and moving to
aligning information and education
around a shared topic. As the
relationship progresses toward
shared values, the expectation is
that interests and priorities are more
aligned and that the impact of the
mutual investment is larger. At the
apex of mission alignment, the goal
of socially responsible investment is
met.
FIGURE 1
Elements of the shared values pyramid.
organization’s product or a specific
issue important to their mission.
These relationships are broader in
terms of their commitment and
support and carry a time-defined
exposure, such as supporting the
AAP’s oral health strategic priority for
2 to 3 years to publish patient
education materials or a time-limited
public awareness campaign.
In a values shared relationship,
ongoing conversations involve
organizational strategy, common
values, and mutual advancement of
priorities. Building this relationship
includes multiple interactions and
engagements, increasingly
transparent communication, and may
involve multiple projects through a
defined time period. One example is
the same corporation sponsoring a
continuing medical education
publication, a Web site, and a toolkit
over multiple years. Organizations
begin to share their unique drivers,
their challenges, and their constraints
for collaboration.
At the apex of the shared values
pyramid is the collaboration to
advance the child health mission. In
this relationship, partners are seeking
optimal alignment to the mission and
positive impact on child health and
wellness. Development of project
support is broader and multiyear
commitments are in place.
Conversations about priorities
surrounding organizations and child
health and well-being occur, as well
PEDIATRICS Volume 136, number 6, December 2015
as mutual learning and sharing of
strengths and knowledge unique
to both organizations. Both
organizations commit to meaningful
advancement and articulation of an
important child health and wellness
goal or the creation of a broad-based
platform that provides needed
support and access to tools that
enhance the mission of child health
and wellness. At this level, there
is transparent discussion of mutual
values, potential barriers to
collaboration, and joint responsibility.
Movement from the base toward
the apex of the pyramid has resulted
in longer-term relationships and
increased sustainability for programs
and initiatives and opportunities for
the AAP to engage with multisector
collaborative initiatives involving
the business community,
With these levels in mind, it is
important to note that the values of
trust, transparency, and cultural
alignment are at the base of the
triangle. These values form the basis
for any discussion of relationship or
partnership and are discussed
with funders before advancement
through the pyramid can occur. They
also serve as touchstones for existing
relationships when difficulties are
encountered or organizational culture
changes and trust needs to be rebuilt.
Process steps along the left side of the
triangle, communication, influence,
and commitment, signify the goals
for deepening the relationship.
The shared values approach has
been approved by the AAP Board
and Executive Committee and the
following are examples of how this
construct has been used in practice.
MAPPING CURRENT RELATIONSHIPS
The AAP development staff used
the pyramid to categorize each of
the corporate relationships they
were responsible for managing. For
example, based on their experience
with the kind of relationship they
had with “corporation A,” they placed
that relationship at the transactional
level, whereas they put “corporation
B” at the values shared level. The staff
was able to easily categorize each
relationship and to identify certain
relationships that could progress
farther up the pyramid toward
mission alignment and others that
seemed to be well categorized and
stable at their current state. This
exercise allowed the staff to consider
how they were resourcing the
work with partners and how to align
staff effort toward the level of
relationship.
TESTING VALUE WITH CORPORATE
PARTNERS
AAP leaders presented the shared
values pyramid to a meeting of
existing corporate and foundation
partners along with the Academy’s
Mission and Agenda for Children.
Corporations responded positively
1179
to the shared values pyramid. All
the corporate partners wanted to
know how the AAP categorized
their relationship on the pyramid
and how to advance their relationship
toward the apex of mission
alignment.
In one case, instead of ceasing
discussion when disagreements
arose, the use of the shared values
pyramid prompted a meeting to have
a specific conversation about how to
build trust, and understand mutual
drivers and barriers.
TESTING VALUE IN A POSITIVE
RELATIONSHIP
CONCLUSIONS
The shared values pyramid was
introduced into discussions with
organizations that had supported
programs and projects over many
years. Its use opened up a new
discussion of the missions of AAP and
the corporation, and brought forward
the desire of the AAP for alignment
around vision and values. It also
facilitated a discussion of the role
of profit and branding as well as
their corporate definitions of shared
value and social responsibility. This
approach increased understanding of
how successful partnerships looked
from both perspectives, what drivers
the corporation was responding to,
and what measures of success might
be used.
TESTING VALUE IN A DIFFICULT
RELATIONSHIP
In relationships that were
encountering difficulty, this tool
was introduced into the discussion
to set the stage for talking about
the foundational values of trust,
transparency, and cultural alignment.
1180
The shared values approach builds on
the AAP’s guidelines for industry and
conflict of interest initiatives. It
reflects the desire of the board and
leadership to engage funders in a new
way. As a tool to encourage healthy
dialogue with regard to new
organizational relationships, the
shared values pyramid has helped
navigating the imperative of
collaborating with a diverse group of
stakeholders to advance the AAP’s
mission and vision while also setting
a framework that promotes
transparency and openness within
and about such relationships. The tool
can be a useful mechanism to forge
new organizational relationships for
the benefit of children, describe the
relationships that currently exist, and
better target resources toward
maximizing alignment and
collaboration.
ABBREVIATION
AAP: American Academy of
Pediatrics
REFERENCES
1. Center on the Developing Child at Harvard
University. 2010. The foundations of lifelong
health are built in early childhood.
Available at: http://www.developingchild.
harvard.edu. Accessed June 3, 2015
2. Garner AS, Shonkoff JP; Committee on
Psychosocial Aspects of Child and Family
Health; Committee on Early Childhood,
Adoption, and Dependent Care; Section on
Developmental and Behavioral Pediatrics.
Early childhood adversity, toxic stress, and
the role of the pediatrician: translating
developmental science into lifelong health.
Pediatrics. 2012;129(1). Available at: www.
pediatrics.org/cgi/content/full/129/1/e224
3. Institute of Medicine and National
Research Council. Children’s Health, the
Nation’s Wealth: Assessing and Improving
Child Health. Washington, DC: The National
Academies Press; 2004
4. Zahner SJ, Oliver TR, Siemering KQ. The
Mobilizing Action toward Community Health
Partnership Study: multisector partnerships
in US counties with improving health
metrics. Prev Chronic Dis. 2014;11:130103
5. Kahn NB Jr, Lichter AS; Council of Medical
Specialty Societies. The new CMSS code for
interactions with companies managing
relationships to minimize conflicts. J Vasc
Surg. 2011;54(suppl 3):34S–40S
6. Council of Medical Specialty Societies.
CMSS code for interactions with
companies. Available at: www.cmss.org/
codeforinteractions.aspx. Accessed
October 11, 2015
7. Porter ME, Kramer MR. Strategy and society:
the link between competitive advantage and
corporate social responsibility. Harv Bus
Rev. 2006;84(12):78–92, 163
HASSINK and HUTCHINS